I certify that I accept all terms and conditions as is on above trip number.

I certify that I am the authorized holder and signer of the credit card referenced above.

I certify that any additional charges incurred due to additional hours or any damages done to the vehicle may be charged to this credit card or due in cash upon completion of service.

I certify that all information above is complete and accurate.

I hereby authorize collection of payment for all charges as indicated above. Charges may not exceed the amount listed above in the "AUTHORIZED AMOUNT DUE" field. I understand this is only for up to this amount during the time period of "DATES OF CHARGES" referenced above. If additional charges are going to be authorized a new form will have to be completed.

Trip confirmation: You will find the trip confirmation number provided in your confirmation email and if you have not received one please call our office to make your booking and obtain a trip confirmation.

For Visa, MasterCard and,
Discover, the CSC is the last three digits in the signature area on the back of your card.

For
American Express, the CSC is a group of four digits on
front of the card.